Health professionals working together for value and science-driven health care
||Mary D. Naylor, Ph.D., RN
Professor, UPenn School of Nursing
Core Principles & Values of Effective Team-Based Health Care
Patient-Clinician Communication: Basic Principles and Expectations
Issue. The presumption of both patients and caregivers in the United States is that the care delivered is the care most appropriate to the need. Yet it is clear that care of proven effectiveness is too often not delivered, and care delivered has too often not been proven effective. In part, the challenge is one of insufficient evidence on the relative effectiveness of diagnostic and treatment options under different circumstances. But it is also the result of the many challenges related to marshaling the available evidence and applying it fully and seamlessly in the context of busy practices, poorly aligned organizational and economic incentives, limited coordination among a patient’s various clinicians, and patient requests driven by forces other than the evidence base. Increased awareness of national shortcomings in both quality and value in the nation’s health care has fueled discussions on approaches to reform. As long as the gap persists between the prevailing patterns of care and best practices readily established for a given condition, health care cannot deliver the value we want and expect.
Collaborative. An ad hoc convening activity under the auspices of the IOM Roundtable, the Best Practices Innovation Collaborative (BPIC) catalyzes joint activities among the health professions for improvement and innovation in health and health care, focusing on fostering evidence-based best practices, including team care and shared decision making.
Participants. Professional organizations representing clinicians on the front lines of healthcare delivery; government agencies actively involved in patient care or programs and policies centrally concerned with the identification and application of best clinical services; and others as indicated by issue. The aim is for an inclusive Collaborative—without walls—and participation in individual projects is structured according to interest, need, and practicality.
Activities. Projects completed, under way, or under consideration by BPIC include:
- Core principles to guide patient-clinician communication. Cooperative development of a set of foundational principles and basic expectations for effective patient-clinician communication throughout the care process. ( joint, with the Evidence Communication Innovation Collaborative)
- Cross-society harmonization in managing co-occurring morbidities. Cooperative development of common, cross-society understandings and expectations with respect to the coordinated and team-based care necessary, when treating patient with multiple chronic conditions, to offset the tendency for fragmented care decisions to compromise the effectiveness and efficiency of care, or even to cause harm.
- Common principles underlying team-based care. White paper on characteristics of high performing inter-professional teams and care models, setting the stage for possible collaborative pilots.
May 1, 2013
October 23, 2012
February 28, 2012
July 27, 2011
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